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Review Article18/03/2025
Short cervix and use of cervical pessary for preventing preterm birth in singleton and twin pregnancies: a systematic review and meta-analysis
- Ana Clara Felix de Farias Santos
, - Nicole dos Santos Pimenta ,
- Ana Gabriela Alves Pereira ,
- Gabriela Oliveira Gonçalves Molino ,
- Maírla Marina Ferreira Dias , [ … ],
- Pedro Henrique Costa Matos da Silva
Resumo
Review ArticleShort cervix and use of cervical pessary for preventing preterm birth in singleton and twin pregnancies: a systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo10
- Ana Clara Felix de Farias Santos ,
- Nicole dos Santos Pimenta ,
- Ana Gabriela Alves Pereira ,
- Gabriela Oliveira Gonçalves Molino ,
- Maírla Marina Ferreira Dias ,
- Pedro Henrique Costa Matos da Silva
Visualizações168Ver maisAbstract
Objective:
Preterm birth remains a significant contributor to neonatal morbidity and mortality. The use of cervical pessaries as an intervention for preventing preterm delivery in women with a short cervix has been a subject of interest. We evaluated the effectiveness of cervical pessary compared to standard care in preventing preterm delivery in women with a short cervix.
Data source:
Databases were systematically searched in PubMed, Cochrane, and Embase databases in December 2023.
Study selection:
Randomized clinical trials with the outcomes of interest were included.
Data collect:
We computed risk ratios for binary endpoints, with 95% confidence intervals. Heterogeneity was assessed using I2 statistics. Data were analyzed using R software (version 4.3.0). The primary outcomes of interest were preterm delivery before 37 weeks, and preterm delivery before 34 weeks.
Data synthesis:
Seventeen studies with 5,704 patients were included. The use of cervical pessary was associated with a decreased risk of preterm delivery before 37 (RR 0.88; 95% CI 0.81-0.96) and 34 weeks (RR 0.79; 95% CI 0.63-0.99) of gestation in twin pregnancies as compared to standard care without progesterone. There were no significant differences in preterm delivery in singleton pregnancy, neonatal outcomes, preterm premature rupture of the membranes or chorioamnionitis.
Conclusion:
The use of cervical pessary was associated with a significant reduction in preterm delivery at 34 and 37 weeks of gestation in twin pregnancies among patients with a short cervix compared to no treatment. No significant difference was found in singleton pregnancies or maternal outcomes.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
- Ana Clara Felix de Farias Santos
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Short Communication18/03/2025
Contraception in adolescents with mental disorders: adherence and satisfaction in the use of depot medroxyprogesterone acetate
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo9
Resumo
Short CommunicationContraception in adolescents with mental disorders: adherence and satisfaction in the use of depot medroxyprogesterone acetate
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo9
Visualizações167Abstract
Objective:
To evaluate the continuation rate, satisfaction, and reasons for discontinuation of depot medroxyprogesterone acetate (DMPA) in adolescents treated in a mental health service.
Methods:
Prospective cohort study conducted in a reference unit for the care of adolescents with mental disorders (MDs) and intellectual disabilities (IDs). All patients received a gynecological consultation and an educational group on contraceptive methods. Sociodemographic data on age, education and gynecological data (menarche, coitarche, regularity of menstrual cycles and presence of symptoms) were collected. Follow-up was quarterly for 12 months, during which symptoms, desire to continue, and satisfaction with the use of the quarterly injectable were assessed.
Results:
Eight hundred and sixty-two sexually active adolescents were supported, 532 adolescents chose to use the quarterly injectable, and 69 of these agreed to participate in the study. The mean age of users was 15.5 years (SD=0.91). After 12 months of follow-up, 34 (49.3%) of the 69 adolescents continued to use the method and 36 (52.3%) were satisfied. Among the 33 (47.8%) who discontinued use, the most common reasons were irregular bleeding and weight gain.
Conclusions:
Adolescents with intellectual disabilities and/or other mental disorders showed a significant rate of continuation and satisfaction with the use of the depot medroxyprogesterone acetate at 12 months, and the most common reasons for discontinuation were irregular uterine bleeding and weight gain.
Palavras-chave: ContraceptionMedroxyprogesterone acetateMental disordersPregnancyPregnancy in adolescenceVer maisThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
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Original Article18/03/2025
The experience of pregnancy in the COVID-19 pandemic
- Mariana Corniani Lopes ,
- Cheryl Tatano Beck ,
- Zelina Hilária de Souza Rosa ,
- Erika de Sá Vieira Abuchaim
Resumo
Original ArticleThe experience of pregnancy in the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo8
- Mariana Corniani Lopes ,
- Cheryl Tatano Beck ,
- Zelina Hilária de Souza Rosa ,
- Erika de Sá Vieira Abuchaim
Visualizações182Ver maisAbstract
Objective:
To describe women’s experience of pregnancy during the COVID-19 pandemic.
Methods:
A qualitative study conducted in a private maternity hospital, from May, 2020 to November, 2021, with women aged ≥ 18 years, gestational age ≥ 36 weeks at birth and ≥ 24 hours post-partum. Data collected through semi-structured interviews, recorded, transcribed, and analyzed adopting Krippendorff’s Content Analysis as theoretical-methodological framework.
Results:
Four main themes emerged: Fear, Taking care and celebrating pregnancy: adjusting to the new reality, Harms of Isolation, and Benefits of Isolation. The fear of contamination and its impact on the health of mother and child resulted in the adoption of severe social isolation, including from those considered sources of support by the expecting mother. Overwhelmed, some of the participants reported loneliness and psychic suffering. The opportunity to focus on the pregnancy, the preparations for the arrival of the child, and the family made isolation a beneficial and positive period for other women.
Conclusion:
The experience of pregnancy in the Pandemic was an event outside of the ordinary and common. The expecting mother faced her worst fears on a daily basis and attended prenatal care, in order to ensure her child would be born healthy. The celebration of the baby’s life, amid so many deaths, had to be adjusted to the virtual environment. It was a tense, solitary, and ambiguous period, which demanded a lot from the mental health of some participants, but to others, brought advantages that would not have been possible in different times.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
- Mariana Corniani Lopes
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Original Article18/03/2025
Effect of COVID-19 on Brazilian cesarean and prematurity rates: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo6
Resumo
Original ArticleEffect of COVID-19 on Brazilian cesarean and prematurity rates: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo6
Visualizações162Abstract
Objective:
To investigate the relationship between prematurity and cesarean section rate in Brazil during the beginning of COVID-19 pandemic.
Methods:
Utilizing the Robson Classification, this study analyzed data from the Brazilian Ministry of Health’s Live Births Panel, comparing CSR) and group 10 (preterm deliveries) between 2019 (pre-pandemic) and 2021 (pandemic) in each of Brazilian states and the overall country. The prematurity and CSR were compared using prevalence ratio and confidence interval, and p-value was obtained. The variation of prematurity and CSR were compared through the coefficient of determination (R2).
Results:
A total of 5,522,910 deliveries were evaluated during the period. The CSR increased from 56.34% to 57.05% (p<0.01), and the frequency of preterm deliveries rose from 8.99% to 9.13% (p<0.01). The CSR increased in 23 States and decreased in 4 States, while the prematurity rate increased in 16 States and decreased in 10 States. A positive relationship between the increase of CSR and prematurity was observed during COVID-19, with an R2 value of 0.3121, suggesting a moderate association between these two variables.
Conclusion:
Between 2019 (pre-COVID-19 pandemic) and 2021 (the first full year of the COVID-19 pandemic), there was an increase in prematurity and CSR in Brazil. These increases were observed in most Brazilian states and may be correlated. However, it is impossible to establish a cause-effect relationship given the design of this study.
Palavras-chave: Cesarean deliveryCOVID-19Infant, newbornLive birthMaternal mortalitypandemicsPrematurityVer maisThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
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Original Article18/03/2025
Accurate evaluation of mode of delivery and labor progression with angle of progression: a prospective cross-sectional
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo5
Resumo
Original ArticleAccurate evaluation of mode of delivery and labor progression with angle of progression: a prospective cross-sectional
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo5
Visualizações150Ver maisAbstract
Objective:
To determine the validity of the angle of progression (AoP) in predicting delivery mode among women in the second stage of labor.
Designs:
This prospective cohort study was conducted at the Obstetrics and Gynecology unit (OBGYN) of two hospitals in Vietnam. Transperineal ultrasound was performed for each woman to measure the progression angle in the second phase of labor.
Participants:
A total of 725 women with singleton pregnancies with cephalic presentation at term
Methods:
Transperineal ultrasound was used to measure the angle of progression in the second labor phase and to identify the delivery method.
Results:
The rate of vaginal birth in women with an AoP ≥ 120° on transperineal ultrasound was 70.2%. The optimal cutoff point of AOP ≥122° with sensitivity and specificity for vaginal birth were 87.8% and 80.7%, respectively the area under the ROC curve of 0.887 (p<0.0001). The study's sample size was restricted owing to deficiencies in resources and time.
Conclusion:
The likelihood of achieving spontaneous vaginal delivery can be predicted by the angle of progression measured with transperineal intrapartum ultrasonography during the second stage of labor in women.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
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Original Article18/03/2025
Gastrin-releasing peptide receptor: a promising new biomarker to identify cervical precursor lesions and cancer
- Martina Lichtenfels ,
- Rafaella Almeida Lima Nunes ,
- Rossana Veronica Mendoza López ,
- Camila Alves da Silva ,
- Luiz Carlos Zeferino , [ … ],
- Lara Termini
Resumo
Original ArticleGastrin-releasing peptide receptor: a promising new biomarker to identify cervical precursor lesions and cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo4
- Martina Lichtenfels ,
- Rafaella Almeida Lima Nunes ,
- Rossana Veronica Mendoza López ,
- Camila Alves da Silva ,
- Luiz Carlos Zeferino ,
- Vanesca de Souza Lino ,
- Adhemar Longatto-Filho ,
- Louise De Brot ,
- Silvia Helena Rabelo-Santos ,
- Daniela Baumann Cornelio ,
- Enrique Boccardo ,
- Caroline Brunetto de Farias ,
- Lara Termini
Visualizações135Abstract
Objective:
This study aimed to verify the relation between gastrin-releasing peptide receptor (GRPR), oncogenic Human Papillomavirus (HPV) and cervical lesions severity.
Methods:
GRPR mRNA levels were evaluated in cervical cancer-derived cell lines and in primary keratinocytes expressing HPV16 oncogenes by RT-PCR. GRPR protein expression was assessed by immunohistochemistry in organotypic cell cultures derived from keratinocytes transduced with HPV16 oncogenes and in 208 cervical samples, including 59 non-neoplastic tissue, 28 cervical intraepithelial neoplasia grade 3 (CIN3), 44 squamous cell carcinomas (SCC) and 77 adenocarcinomas (ADC). Generic primers (GP5+/GP6+) were used to identify HPV infection in tissue samples. Experiments involving cell lines were analyzed through non-parametric tests (Kruskal Wallis), and Fisher’s Exact Test for human tissues samples. All statistical tests were considered significant at p <0.05. Immunohistochemical evaluation was conducted independently and blindly by two observers (AD- LO). Any discordant findings were resolved through discussion to reach a consensus score.
Results:
GRPR mRNA levels were not increased in cells expressing HPV16 or HPV18 oncogenes. However, at the protein level, GRPR was upregulated in organotypic cell cultures containing HPV oncogenes. Besides, it was identified an association between GRPR expression and cervical lesion severity (p < 0.0001). The detection rate of high-risk HPV DNA was directly correlated with cervical disease. Nonetheless, HPV infection was not directly associated with GRPR in cervical samples.
Conclusion:
GRPR expression is highly predictive of cervical lesion severity, irrespective of HPV infection and might contribute to improving patient’s therapeutic management as well as being used a marker of disease progression.
Palavras-chave: AdenocarcinomaCarcinoma, squamous cellGastrin-releasing peptide receptorHuman papillomavirusOncogenesPapillomavirus infectionsUterine cervical dysplasiaUterine cervical neoplasmsVer maisThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
- Martina Lichtenfels
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Review Article18/03/2025
Low-level laser therapy for nipple trauma and pain during breastfeeding: systematic review and meta-analysis
- Maria Victória Candida Gaitero ,
- Ticiana Aparecida Alves de Mira ,
- Edna Jéssica Lima Gondim ,
- Simony Lira do Nascimento ,
- Fernanda Garanhani Surita
Resumo
Review ArticleLow-level laser therapy for nipple trauma and pain during breastfeeding: systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo3
- Maria Victória Candida Gaitero ,
- Ticiana Aparecida Alves de Mira ,
- Edna Jéssica Lima Gondim ,
- Simony Lira do Nascimento ,
- Fernanda Garanhani Surita
Visualizações144Abstract
Objective:
This study aimed to investigate the effect of low-level laser therapy (LLLT) on nipple trauma and pain during breastfeeding through a systematic review with a meta-analysis of selected studies.
Source of the data:
A thorough search was conducted on March 22, 2022, using the databases PubMed, SciELO, LILACS, PEDro, CINAHL, EMBASE, ScienceDirect, Scopus, Google Scholar, MEDLINE, the Cochrane Library, Clinical Trials, Web of Science, TRIP, DARE, and ProQuest. The search terms included various combinations of low-level laser therapy, nipple pain, nipple trauma, and breastfeeding.
Studies selection:
Out of 107 articles identified, only three controlled and randomized clinical trials was included. The extracted data encompassed breast and trauma characteristics, treatment types, outcomes (pain and healing process), evaluation tools, LLLT usage, laser brand, and parameters.
Data collection:
Data extraction was performed using RAYYAN for systematic reviews. The risk of bias in the studies was evaluated.
Data synthesis:
Pain was measured using the visual analog scale (VAS). The included studies did not use validated tools for assessing physical conditions. All studies employed LLLT with a 660-nm wavelength, though there were variations in equipment power, energy dose, and application methods. The meta-analysis revealed an average difference of −0.60 points (95% CI: −1.52 to 0.31) in the VAS pain scores between the LLLT and control groups. No heterogeneity was observed among the studies (I2=0%), indicating no significant difference in pain relief between LLLT (red light) and control groups.
Conclusion:
LLLT may offer a promising option for managing breastfeeding-related complications, though further research is required.
Palavras-chave: Breast feedingLaser therapyLow level light therapyLow-level laserNipple painNipple traumaNipplesVer maisThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
- Maria Victória Candida Gaitero
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Review Article18/03/2025
Clinical repercussions of statin use during pregnancy: a review of the literature
- Joan Lins Serafim ,
- Pedro Lucas Santos de Menezes Teles ,
- Amanda Katharinne Souza Lima ,
- Jéssica dos Santos Coelho ,
- Paloma Luna Maranhão Conrado , [ … ],
- George Alessandro Maranhão Conrado
Resumo
Review ArticleClinical repercussions of statin use during pregnancy: a review of the literature
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo2
- Joan Lins Serafim ,
- Pedro Lucas Santos de Menezes Teles ,
- Amanda Katharinne Souza Lima ,
- Jéssica dos Santos Coelho ,
- Paloma Luna Maranhão Conrado ,
- Valda Lúcia Moreira Luna ,
- Pauliana Valéria Machado Galvão ,
- George Alessandro Maranhão Conrado
Visualizações122Abstract
Statins are the most widely used pharmacological class for treating hyperlipidemia, although they are contraindicated during pregnancy. This study aims to demonstrate the clinical effects of statins in pregnant women through an interactive review. Fifteen original articles were selected, in English or Portuguese, within of five years. Statins have not been associated with the development of fetal malformations and their use may be useful in preventing unfavorable cardiovascular outcomes, with the potential to reduce oxidative stress and angiogenic dysfunction. However, the use of statins to prevent pre-eclampsia in humans has not been properly clarified and further studies are needed. Pravastatin is considered safer than statins for use during pregnancy.
Palavras-chave: Antihypertensive agentsHydroxymethylglutaryl-CoA reductase inhibitorsPravastatinPre-eclampsiaPregnancyPregnant womanVer maisThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
- Joan Lins Serafim
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